Development rate of chronic kidney disease in hepatitis C virus patients with advanced fibrosis after interferon therapy.

Abstract

AIM:

  The aim of this retrospective cohort study is to assess the development incidence and predictive factors for chronic kidney disease (CKD) after the termination of interferon therapy in hepatitis C virus (HCV) positive Japanese patients with liver cirrhosis.

METHODS:

  A total of 650 HCV positive, liver cirrhotic patients who were treated with interferon and showed an estimated glomerular filtration rate (eGFR) of ≥60 mL/min per 1.73 m(2) after the termination of interferon therapy were enrolled. CKD was defined as an eGFR of <60 mL/min per 1.73 m(2) . End-stage-CKD was defined as an eGFR of <15 mL/min/1.73 m(2) . The primary goal is the new development of CKD and end-stage-CKD.

RESULTS:

  Eighty-five patients developed CKD, and six patients progressed to end-stage-CKD. The development rate of CKD was 5.2% at the 5th year, 14.5% at the 10th year and 30.6% at the 15th year. Multivariate Cox proportional hazards analysis showed that CKD occurred when patients had age increments of 10 years (hazard ratio: 2.32; 95% confidence interval [CI] 1.61-3.35; P < 0.001), eGFR decrements of 10 mL/min per 1.73 m(2) (hazard ratio: 1.66; 95% CI 1.27-2.16; P < 0.001), hypertension (hazard ratio: 2.00; 95% CI 1.13-3.53; P = 0.017), diabetes (hazard ratio: 1.79; 95% CI 1.02-3.14; P = 0.042), and non-clearance of HCV (hazard ratio: 2.67; 95% CI 1.34-5.32; P = 0.005). The development rate of end-stage-CKD was 0.4% at the 5th year, 1.6% at the 10th year and 2.8% at the 15th year.

CONCLUSIONS:

  The annual incidence for CKD among cirrhotic patients with HCV was determined to be about 1.0-1.5%. In addition, the annual incidence for end-stage-CKD is one order of magnitude lower than that of CKD.

• Authors: Yasuji Arase, Fumitaka Suzuki, Yusuke Kawamura, Yoshiyuki Suzuki, Masahiro Kobayashi, Naoki Matsumoto, Norio Akuta, Hitomi Sezaki, Tetsuya Hosaka, Kyoko Ogawa, Norihiro Imai, Yuya Seko, Satoshi Saito, Kenji Ikeda, Mariko Kobayashi, Hiromitsu Kumada
• Journal: Hepatology research : the official journal of the Japan Society of Hepatology (Hepatol Res) Vol. 41 Issue 10 Pg. 946-54 (Oct 2011) ISSN: 1872-034X [Electronic] Netherlands
• PMID: 21883737 (Publication Type: Journal Article)
• Copyright: © 2011 The Japan Society of Hepatology.